Cervical collar having height adjustment

ABSTRACT

A cervical collar has an anterior component including a lower support that is adjustable in angle relative to a main support. The lower support is hingedly connected to the main support at first and second end portions. An elongate element engages the first and second end portions. A lock mechanism is operatively connected to the elongate element, and is arranged for locking rotation of the lower support relative to the main support, by moving the elongate element between locked and unlocked conditions. An upper support is received by the main support at least at a front section of the main support, and is arranged to be fitted against a user&#39;s chin.

CROSS-REFERENCE TO RELATED APPLICATIONS

This disclosure incorporates by reference U.S. Pat. No. 5,632,722,granted May 27, 1997, U.S. Pat. No. 6,254,560, granted Jul. 3, 2001,U.S. Pat. No. 7,981,068, granted Jul. 19, 2011, U.S. Pat. No. 8,038,636,granted Oct. 18, 2011, U.S. Pat. No. 8,679,044, granted Mar. 25, 2014,U.S. Pat. No. 9,713,546 granted on Jul. 25, 2017, and U.S. patentapplication publication no. 2016/0287424, published Oct. 6, 2016.

FIELD OF THE DISCLOSURE

The present disclosure relates to an orthopedic device, and morespecifically to cervical collars having height adjustability at a frontpart, while providing a platform for securing known other components ofa cervical collar thereto without modifying their anatomical contoursand connection to the height adjusted components.

BACKGROUND

Cervical collars are used for treating conditions of the neck and thecervical spine by cervical spine immobilization. These collars mayhandle whiplash and other such injuries, where support for the head andneck of the patient is needed, and function to partially immobilize thehead and neck of the patient and relieve spasm or strain to which theneck muscles of the patient might be subjected by transferring weight orforce from the head of the patient to the shoulders or adjacent areas ofthe patient. Other collars may be arranged for complete or near completeimmobilization of the head and neck of the patient to reduce risk ofsecondary damage to the spinal cord.

A challenge in designing a cervical collar is balancing desiredimmobilization with user comfort, such as venous pressure.Immobilization may be measured by five planes of movement, includingflexion, extension, lateral tilt to right and left, and rotation of theneck to right and left, and is considered generally as cervical range ofmotion (CROM).

Unfortunately, many patients using cervical collars develop decubitus ordecubitus ulcers (also known as bed sores, pressure sores, or trophiculcers) when wearing cervical collars. These ailments, which involve abreakdown of tissue overlying a bone, arise when tissues overlying abony prominence are subjected to prolonged pressure against an objectsuch as a cervical collar. Besides affecting superficial tissues such asthe skin, decubitus and decubitus ulcers also can affect muscle andbone. Restrictive collars are the root causes of skin breakdown in thetrauma population. As pressure-ulcers are among the most common, yetserious and costly, complications of routine spinal immobilization, itis desirable to provide cervical collars that minimize the probabilityof ulcers.

Moisture and pressure are two major factors which contribute to theformation of decubitus. Once a decubitus ulcer forms, there is no goodmethod of determining the extent of tissue damage. Once started,decubitus can continue to progress through the skin and fat tissue tomuscle and eventually to bone, and is very difficult to treat andarrest. In extreme cases, surgical replacement of bone, muscle and skinare required to restore that portion of the body of the patient wheredecubitus has formed.

It is desirable to eliminate or at least minimize the effect of pressurepoints when using cervical collars. The likelihood of contractingdecubitus can be greatly reduced by a more even distribution of pressureto several parts of the body of the patient.

Multiple studies have evaluated CROM and the likelihood oftissue-interface pressure (TIP) exerted by commercially-availablecervical collars. One of the known commercial collars that has provensuccessful at striking the balance of minimal TIP and most restrictionof CROM is the Miami J collar (Ossur, hf, Reykjavik, Iceland). Multiplestudies have validated the features of the Miami J collar, including:Tescher, A. N. et al. Range-of-motion restriction and craniofacialtissue-interface pressure from four cervical collars. Journal ofTrauma-Injury Infection & Critical Care: 2007; 63; 5; 1120-1126;Jacobson, T. M. et al. Efforts to reduce occipital pressure ulcers.Journal of Nursing Care Quality; 2008; 23; 3; 283-288; Karason, S. etal. Evaluation of clinical efficacy and safety of cervical traumacollars: differences in immobilization, effect on jugular pressure andpatient comfort. Scandinavian Journal of Trauma, Resuscitation andEmergency Medicine. 2014. 22:37.

The Miami J collar is also described in U.S. Pat. No. 5,632,722, grantedMay 27, 1997; U.S. Pat. No. 6,254,560, granted Jul. 3, 2001; U.S. Pat.No. 6,921,376, granted Jul. 26, 2005. Variations of the Miami J collar,embodying the Miami J Advance collar, are described in U.S. Pat. No.7,981,068, granted Jul. 19, 2011, and U.S. Pat. No. 8,679,044, grantedMar. 25, 2014.

A feature, preferably included in cervical collars to overcome limitedadaptability to accommodate the body of the patient and the particularailment prompting the need for wearing a cervical collar, is thefacility for adjusting the relative positions of various components ofthe cervical collar. Part of the effectiveness of the Miami J collar isdue to its ability for customization to different anatomical sizes ofusers.

As taught in U.S. Pat. No. 6,254,560, the Miami J collar has supportsthat enable customized pressure distribution and avoid skin breakdown. Afront part of the Miami J collar has an adjustable upper support for themandibular, chin and/or jaw of the user, and mounted to a lower supportor sternum brace by means which permit relative movement between theupper support and the lower support. The posterior component or backpart of the Miami J collar has an occipital support mounted to a backsupport by means which permit relative sliding movement between theoccipital support and the back support. The shape of the upper supportand occipital support are anatomically optimized for superiorimmobilization and patient comfort.

Both the upper support and the occipital support of the Miami J collarare uniquely anatomically shaped to maximize comfort and immobilizationwhile minimizing pressure on the user. Because the upper support and theoccipital support of the Miami J collar are clinically proven, it isdesired that any improvements over the current Miami J collar providemeans for preserving the function and shape of the upper support andoccipital support of the current Miami J collar.

SUMMARY

The present disclosure describes an improved cervical collar forrestricting head and neck movement to promote healing after an injury tothe spinal column. The cervical collar has height, circumferential andangular adjustment to accommodate a wide variety of patient sizes andanatomical configurations, and to accommodate dimensional changes causedby increased or decreased swelling of the affected anatomical portionsof the patients during treatment of the injury. The cervical collar isarranged to stabilize and immobilize the cervical area, by restrictinglateral, sagittal and coronal movement, while improving comfort, and fitfor individual patients.

Embodiments of the disclosure relate to a cervical collar having aheight adjustment system between main and lower parts forming ananterior component, which permit the use of known upper and occipitalsupports in the cervical collar to maintain their functionality, comfortand fit, including their anatomical contours and connection to theheight adjusted components. The height adjustment system is arranged foradjusting the chin height in a simple and effective manner that limitsor mitigates tampering with the height while the collar is worn. Theheight adjustment system preferably includes using incremental heightadjustment so the height may be locked at a desired height setting. Theheight adjustment system may be arranged to allow usage in existingcollar designs, such as the Miami J or Miami J Advance collars, withoutsubstantially altering the shape and function of the mandibular andposterior component including an occipital support.

The height adjustment system mitigates or eliminates the need forpre-sizing methods, and is provided in a simplified manner to enablemany height settings customizable for different users. The heightadjustment system allows use of known upper and posterior components,which have been on the market for many years to serve many users ofcervical collars, are clinically proven for their efficacy.

The height adjustment system allows for improved placement andconfiguration of a cervical collar on patients of different heights. Theupper support and posterior component can be properly fitted against thechin and head of a patient by a clinician, followed by the extension ofthe anterior component against the patient's chest. Likewise theanterior component may be placed against the patient's chest and theupper support and posterior component can then be extended to the chinand head of the patient. The height setting can then be locked at thedesired height setting by the clinician to ensure a proper fit for theuser.

According to a general embodiment, a cervical collar has an anteriorcomponent arranged for connecting to a posterior component. The anteriorcomponent comprises a main support, and a lower support hingedlyconnected to the main support at first and second hinges. An elongateelement or slidelock has first and second ends engaging the first andsecond hinges, such that the first and second ends are arranged foradjusting relative to the first and second hinges. A lock mechanism isconfigured for locking rotation of the lower support relative to themain support, and moving the elongate element between locked andunlocked conditions. The elongate element is biased into the lockedcondition, and may be configured to wedge parts of the hinged connectionof the parts of the anterior component together in the locked condition.

In a method for adjusting an angle defined between the main support andthe lower support, the method involves moving the elongate elementrelative to the main support and the lower support. A part of the mainsupport is disengaged from a corresponding part of the elongate elementto unlock the lower support from the main support. The lower support ismoved relative to the main support. Once the lower support is placed atthe desired angle relative to the main support, the part of the mainsupport is engaged to the corresponding part of the elongate element tolock the lower support to the main support, which may be accomplish bywedging parts of the hinged connection together.

These and other features, aspects, and advantages of the presentdisclosure will become better understood regarding the followingdescription, appended claims, and accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawing figures are not necessarily drawn to scale, but instead aredrawn to provide a better understanding of the components thereof, andare not intended to be limiting in scope, but to provide exemplaryillustrations. The figures illustrate exemplary configurations of anorthopedic device, and in no way limit the structures or configurationsof a liner according to the present disclosure.

FIG. 1 is a perspective view of a known cervical collar under thecommercial name Miami J.

FIG. 2A is a frontal elevational view of a cervical collar.

FIG. 2B is a side elevational view of an embodiment of a cervical collarof FIG. 2A.

FIG. 3A is a top plan view of the main and lower supports of thecervical collar of FIG. 2A.

FIG. 3B is a rear elevational view of the main and lower supports of thecervical collar of FIG. 2A.

FIG. 4 is a detail plan view of the lock mechanism in FIG. 3A.

FIG. 5 is a schematic view of a variation of the lock mechanism of FIG.3A.

FIG. 6A is a schematic plan view of the elongate element in a lockedcondition.

FIG. 6B is a schematic plan view of the elongate element in an unlockedcondition.

FIG. 7A is a schematic perspective view of the first hinge in a lockedcondition.

FIG. 7B is a schematic perspective view of the first hinge in anunlocked condition.

FIG. 8A is a schematic perspective view of a variation of the firsthinge in a locked condition.

FIG. 8B is a schematic perspective view of the first hinge of FIG. 8A inan unlocked condition.

FIG. 9A is an outer exploded perspective view of another variation ofthe first hinge.

FIG. 9B is an inner exploded perspective view of the first hinge of FIG.9A.

FIG. 10 is a perspective view of another embodiment of a cervicalcollar.

FIG. 11 is a perspective view of an embodiment of a slidelock in thecervical collar of FIG. 10 and showing a first side thereof.

FIG. 12 is a perspective detail view of the slidelock showing a secondside thereof.

FIG. 13 is a perspective schematic view showing the slidelock of FIG. 11in a portion of the cervical collar of FIG. 10.

FIG. 14A is a perspective schematic view showing the slidelock of FIG.11 in an end portion of side A of the cervical collar of FIG. 10 in alocked condition.

FIG. 14B is a perspective schematic view showing the slidelock of FIG.11 in an end portion of side B of the cervical collar of FIG. 10 in anunlocked condition.

FIG. 14C is a detail cross-sectional view XIV C of FIG. 14A showingengagement of features in a locked condition of the collar of FIG. 10.

FIG. 15A is a perspective view of an inside surface of a side cover inthe cervical collar of FIG. 10.

FIG. 15B is a schematic view of a variation of the side cover and mainsupport in FIG. 15A.

FIG. 16A is a schematic view of a variation of a paddle in a slidelock.

FIG. 16B is a schematic view of another variation of a paddle in aslidelock.

FIG. 17 is a schematic view of another variation of a slidelock systemfor use in a cervical collar.

FIG. 18A is a schematic view of another variation of a slidelock systemfor use in a cervical collar.

FIG. 18B is a schematic view of the slidelock system in FIG. 18Adisassembled.

FIG. 18C is a schematic view of the slidelock system in FIG. 18A in alocked condition.

FIG. 18D is a schematic view of the slidelock system in FIG. 18A in anunlocked condition.

FIG. 19A is a schematic side elevational view of the upper support inthe main support.

FIG. 19B is schematic view of the adjustability of the upper supportrelative to the main support in FIG. 19A.

FIG. 20 is a plan view of the adjustment mechanism in FIG. 2A.

FIG. 21 is an elevational view of the adjustment mechanism of FIG. 20.

FIG. 22A is a schematic elevational view of the adjustment mechanism ina contracted configuration.

FIG. 22B is a schematic elevational view of the adjustment mechanism inan extended configuration.

FIG. 23A is an elevational view of an embodiment of the connector inFIG. 2.

FIG. 23B is a top plan view of the connector in FIG. 23A.

FIG. 24A is a perspective view of another embodiment of the connector inFIG. 2.

FIG. 24B is an exploded view of the connector in FIG. 24A.

DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS A. Introduction

Embodiments of an orthopedic device are provided for stabilizing andsupporting anatomical portions of a wearer, for example, the neck andhead of a wearer.

Although the embodiments of the disclosure are adapted for supportingand stabilizing anatomical portions of many wearers having variousanatomical shapes and sizes, the embodiments of the disclosure may alsobe dimensioned to accommodate different types, shapes and sizes ofanatomical portions.

A better understanding of different embodiments of the disclosure may behad from the following description read with the accompanying drawingsin which like reference characters refer to like elements.

While the disclosure is susceptible to various modifications andalternative constructions, certain illustrative embodiments are in thedrawings and are described below. It should be understood, however,there is no intention to limit the disclosure to the embodimentsdisclosed, but on the contrary, the intention covers all modifications,alternative constructions, combinations, and equivalents falling withinthe spirit and scope of the disclosure.

It will be understood that, unless a term is defined in this disclosureto possess a described meaning, there is no intent to limit the meaningof such term, either expressly or indirectly, beyond its plain orordinary meaning.

While the foregoing embodiments have been described and shown,alternatives and modifications of these embodiments, such as thosesuggested by others may be made to fall within the scope of theinvention. While the cervical collar has been described in combinationwith collar parts, it will be understood that the principles describedmay be extended to other types of orthopedic and prosthetic devices.

Reference characters are provided in the claims for explanatory purposesonly and are not intended to limit the scope of the claims or restricteach claim limitation to the element in the drawings and identified bythe reference character.

For ease of understanding the disclosed embodiments of an orthopedicdevice, the front or anterior, and rear or posterior portions of theorthopedic device are described independently. The anterior andposterior portions of the orthopedic device function together to form asupporting and stabilizing collar that encompasses the anatomicalportions of the wearer.

The term “posterior” also has its ordinary meaning and refers to alocation that is behind or to the rear of another location. Lastly, theterm “anterior” has its ordinary meaning and refers to a location aheadof or to the front of another location.

The terms “rigid,” “semi-rigid,” “flexible,” and “compressible” may beused herein to distinguish characteristics of portions of certainfeatures of the orthopedic device. The term “rigid” should denote thatan element of the device is generally devoid of flexibility. Within thecontext of support members or shells that are “rigid,” it is intended toindicate that they do not lose their overall shape when force isapplied, and they may break if bent with sufficient force. As for theterm “semi-rigid,” this term is used to connote properties of supportmembers or shells that provide support and are free-standing; howeversuch support members or shells may have some degree of flexibility orresiliency.

The term “flexible” should denote that features are capable of repeatedbending such that the features may be bent into retained shapes or thefeatures do not retain a general shape, but continuously deform whenforce is applied. The term “compressible” is used to qualify suchstructural features as being capable of being reduced in size or volumedue to the exertion of force applied to the structural feature.

B. Components for Use with Following Embodiments

FIG. 1 exemplifies the known Miami J collar 1, as taught in theaforementioned patents and publications, particularly U.S. Pat. Nos.5,632,722 and 6,254,560. The collar 1 includes an upper support 2intended to support the mandibular, jaw or chin of the user that securesand/or rests upon an anterior component 3 of the collar. The uppersupport 2 is arranged for sliding movement with the anterior component 3and for locking therewith by a side adjustment connection 11 and acentral tab 15. The upper support 2 preferably has continuous padding 8along a surface adjacent the user's jaw.

The anterior component 3 defines a sternum part 4, forming an extensionadapted to extend below the clavicle of a user and adapted to restagainst the sternum. The sternum part 4 carries a sternum pad 9 to avoiddecubitus over long periods of wear of the collar. Besides the sternumpad 9, the anterior part 3 likewise includes padding along the surfacefacing the user.

The Miami J collar may be used by users with injuries other than thosefor which the cervical collar is most commonly used. The anteriorcomponent 3 forms an opening 13 which allows for access to the throat ofthe user, although because the anterior component is unitary andmonolithic, the size of the opening 13 remains fixed.

The collar 1 includes a posterior component comprising lower and upperparts 5, 6, with the upper part serving as an occipital support. Boththe lower and upper parts 5, 6 preferably include continuous padding,with the lower part intended to rest upon the back of the user, and theupper part intended to rest against the occiput of the head. The lowerand upper parts 5, 6 are preferably attached for relative slidingmovement between relative positions of the lower and upper parts toallow for different head sizes and proper and even pressure distributionacross the body of the user.

Although not shown, the posterior component may be unitary andmonolithic because it resembles the posterior component taught by U.S.Pat. No. 7,981,068 and found in the Miami J Advance collar. Theposterior component is an anatomically configured 3D supportcontiguously formed with resilient or compliant edges. The supportincludes slots to provide ventilation and/or additional resilience orflexibility. The support portion also includes an anatomically shapedflared section shaped to correspond to and support an anatomical portionof a wearer, for example, the occipital region.

Both the upper support, and the anterior and posterior components aregenerally symmetrical about a vertical center line, and may be formedfrom rigid or semi-rigid plastic. The material forming the uppersupport, and the anterior and posterior components, may be flexibleprior to donning the collar, but sufficiently rigid once the collar isdonned to resist yielding due to weight exerted by the user.

A fastener 7 is used to secure the anterior and posterior components toone another. The fastener 7 comprises cooperating hook-and-loopattachments on the anterior and posterior components, with a strapbearing hook material extending from the posterior component and loop orhook receiving elements located on the anterior component.

Each of these embodiments is arranged to receive the upper support andposterior component of the Miami J collar, or the posterior component ofthe Miami J Advance collar in order to preserve the clinicallyrecognized superior immobilization and comfort provided by the existingcollars. It will be noted, however, that these embodiments are notrestricted to only the upper support and posterior component of theMiami J and Miami J Advance collars, but can receive other upper supportand posterior components of other known collars or those designed foreach of the embodiments.

The height adjusted anterior component is arranged to preserve theanatomical contour and function of the known upper support and posteriorcomponent, despite the height adjustment of the anterior component andthe tracheal opening thereof. The embodiments may have a varying heightadjustment in that a center portion of the collar about the trachealopening and generally along a vertical center line may increase greaterin height than alongside portions of the anterior component proximatethe connection to the posterior component. An example, although notlimiting, is a 3:1 height difference at the center portion relative tothe side portions.

While the embodiments may be associated with varying neck lengths amongusers, the sternal contour of users may likewise vary. The varyingsternal contours of users may be resolved by positioning of the sternalcontour, which may be achieved by adjusting the tracheal opening heightor the height generally of the collar. While anatomical vertebral heightand neck length plays a role in adjustment of the collar, the alignmentof the spinal segments also has an effect in overall neck “length,”i.e., a more kyphotic or flexed neck position “shortens” an otherwiseanatomically longer or taller neck.

Another factor relating to the dimension of the cervical collar is thesternal contour. For instance, a very barrel chested individual (havinga more horizontal sternal contour) may have the distal most dimension ofthe sternal extension of the brace contact considerably closer to themandible than the patient with a very vertical sternum.

In all situations suggested above, mandible dimensions would berelatively the same, it is the orientation of the neck elements and itsattachment to and the contour of the sternal segment that plays thelargest role in overall collar height adjustment. The mechanismaffording mandible and sternal height adjustment can accommodate thevarying contours and dimensions.

C. Embodiments of the Cervical Collar

According to the embodiment of FIGS. 2A and 2B, a cervical collar 10 hasan anterior component 12 arranged for connecting to a posteriorcomponent 14. The posterior component 14 may be similarly arranged asthe similar part in U.S. Pat. No. 7,981,068, as discussed above. Theanterior component 12 comprises a main support 16, an upper support 18arranged for being received by the main support 16, and a lower support20 hingedly connected to the main support 16 at first and second hingesor end portions of the main and lower supports forming such hinges. Inthe depicted embodiments, the first and second hinges are formed by suchend portions of the main and lower supports, and there are not separatehinges in addition to the end portions. However, the application is notlimited to such arrangement, and additional components could be added tothe end portions of the main and lower supports which could beconsidered as hinges in addition to the end portions of the main andlower supports.

A lock mechanism 22 is arranged for locking rotation of the lowersupport 20 relative to the main support 16, such that the hinges arelocked according to different angular configurations of the lowersupport 20 relative to the main support 16. An adjustment mechanism 24is located centrally along a lowermost portion of the lower support 20,and may be configured for adjustment relative to and away from a sternumof a user for improving comfort and fit of the cervical collar.

As evident from FIGS. 2A and 2B, the anterior component 12 preserves thegeneral contours known in the Miami J collar, particularly theperipheral outline of the anterior component of both the main support 16and lower support 20, which enables easy attachment to the known upperor upper support 18 and posterior component 14. Specifically, the uppersupport 18 may have a configuration that is the same as in U.S. patentapplication publication no. 2013/0310722, and U.S. Pat. No. 6,254,560.The profile of the upper support 18 is preferably taken from the Miami Jcollar, however other upper supports may be used and the embodiments arenot limited to solely the Miami J collar profile.

Because the main and lower supports are adjustable relative to oneanother, the upper support is preferably maintained in a stationaryrelationship with the main support. However, the upper support is notnecessarily rigid, but may flex according to the anatomy of the user,but become rigid or stable to movement once the collar is placed andtightened securely on the user.

Generally, when fitting a cervical collar having an anterior component12, a clinician fits the upper support 18 and posterior component 14against a patient's chin and head, arranged for the desired level ofimmobilization and support. The clinician then adjusts the lockmechanism 22 to secure the anterior component 12 against the chest andshoulders of the patient by articulating the lower support 20 relativeto the main support 16. A clinician may also first fit the anteriorcomponent 12 against the patient's chest and then regulate the lockmechanism 22 to extend the main support 16 and posterior component 14 tothe chin and head of the patient. The height setting is maintained bythe lock mechanism 22 once released at the desired height setting toensure a proper fit for the user.

Referring to FIGS. 6A and 6B, the first and second ends 48, 50 of anelongate element 34 or sliding lock or slidelock, as discussedperiodically herein, are spatially located differently relative to thefirst and second hinges 40, 42 when in the unlocked condition. The firstend 48 is axially offset from axis 49 from end portions 44, 46 of themain support and the lower support at the first hinge 40 in the unlockedcondition. The end portions 44, 46 of the main and lower supports aregenerally coaxial relative to one another.

As illustrated in FIGS. 3A, 3B and 4, the elongate element 34 isslidably located within an arcuate guide 54 defined by the main support16 along an inner side I thereof. The inner side I of the main support16 defines a plurality of guides 38 for retaining the elongate element34 within the arcuate guide 54. According to the illustrated embodiment,the guides 38 each define a post 52 having a height greater than athickness of the guides 38. The arcuate guide is depicted as a tray butit may likewise be configured as a flange, boss, segmented protrusions,or other appropriate structure to route the elongate element of the mainsupport or upper support.

The arcuate tray 54 is defined by a base portion 58 and an upper wall 56of the main support 16. The base portion 58 extends outwardly from theupper wall 56 in a generally perpendicular orientation.

The main support 16 has a generally arcuate configuration 59 adapted toextend about the mandible of a user, and may be considered to possessesan elongated C- or U-shape. The lower support has a generally arcuateconfiguration 60 and is contoured for being adapted for securing againsta sternum of a user.

The lock mechanism 22 includes an actuator or dial 30 for adjusting thelock mechanism 22 from locked to unlocked conditions. The lock mechanism22 includes the elongate element 34 having first and second ends 48, 50engaging the first and second hinges 40, 42. The first and second ends48, 50 are arranged for being displaceable relative to the first andsecond hinges 40, 42 between locked and unlocked conditions of the lockmechanism 22.

The lock mechanism 22 preferably includes a pinion 32 and a rack segment36, or geared rack segment 36, for adjusting position of the elongateelement 34. The pinion 32 defines a shaft 61 extending between the outerand inner sides of the main support 16 and a pinion portion 62 at afirst end of the shaft 61. The shaft 61 engages the actuator 30 on theouter side of the main support 16 at a second end of the shaft 61. Thepinion portion 62 engages a rack segment 36 defined by the elongateelement 34, whereby rotation of the shaft 61 urges the elongate element34 to slide relative to the main support 16.

The pinion portion 62 is recessed relative to the shaft 61, such thatthe shaft 61 has a diameter greater than the pinion portion 62. Thepinion portion 62 is arranged to maintain engagement with the racksegment 36 of the elongate element 34. An end portion 63 of the pinionon the inner side preferably has a diameter greater than the pinionportion 62. The pinion portion 62 is recessed relative to the shaft 61and the end portion 63. The shaft 61 engages a periphery of an opening67 of the main support 16 via a threaded engagement 65.

While a rack and pinion system is shown and described, other adjustmentand engagement systems may be used in combination with the elongateelement or slidelock. Such other adjustment and engagement systems maybe rotary or linear in nature, such as a slider, for causingdisplacement of the elongate element relative to the main support.

In the embodiment of FIG. 4, the lock mechanism 22 includes a least onespring element 64 arranged for returning the shaft 61 to a lockedcondition after rotation of the shaft 61 to the unlocked condition ofthe first and second hinges 40, 42 and release of the actuator 30. Thespring element 64 is a Belleville disc. The spring element 64 biasesagainst a groove 71 formed by the shaft 61 and a bias element 69 of themain support 16. The return force from the elongate element 34 may drivethe actuator into the locked condition.

According to the schematic representation in FIG. 5, the lock mechanism22 has at least one elastic element 66A, 66B secured at a first end to afirst retainer 73 on the main support 16 and a second retainer 75 on thelock mechanism 22, whereupon release of the lock mechanism, the at leastone elastic element 66A, 66B urges the lock mechanism to a predeterminedconfiguration. The actuator 30 may be resiliently or spring biased, suchthat it may be activated under force to an unlocked condition wherebysuch force returns the actuator to a predetermined locked condition; forexample by merely releasing the actuator.

Referring to the depiction in FIGS. 7A and 7B, the first hinge or endportion 40 includes end portions 44, 46 of the main support and thelower support 16, 20, respectively, and a hinge cover 68 defining a hole74. The end portions 44, 46 each define holes 78, 80 that are coaxialabout a first axis 90 to one another and about which the first hinge orend portion 40 pivots. The first end 48 of the elongate element 34 isarranged to slidably adjust relative to the end portions 44, 46. Thefirst end 48 defines an opening 76 axially offset from the first axis 90and defined along a second axis 91 variable in location depending on theconfiguration of the lock mechanism 22.

The first end 48 of the elongate element 34 defines a detent projection72 arranged to engage a ridge 86 defined by the end portion 44 of themain support. The end portion 44 defines a ramp 87 leading to the ridge86 from a recess 88 defined by the end portion 44. The detent projection72 is arranged to be received by the recess 88 and slide along the ramp87 to the ridge 86 between locked and unlocked conditions of the lockmechanism 22. The ridge 86, the ramp 87 and the recess 88 are generallyconcentric with the first axis and the hole 78 of the main support 16.

A spring element 70, such as an O-ring, is concentrically disposed aboutthe hole 78 of the main support and biased between a shoulder 92 definedby the main support 16 and an inner surface 94 of the cover 68. As shownin FIG. 7A, when the spring 70 is in an expanded configuration, itwedges the inner surface 94 of the cover 68 and the shoulder 92together.

The end portion 46 of the lower support 20 defines a protrusion ordetent 84 arranged to be received by a notch 82 defined by the endportion 44 of the main support. The detent 84 is received by the notch82 in the locked condition of the main support and the lower support.The detent 84 is generally arranged concentrically with the hole 80 ofthe main support. As shown in FIG. 7A, in the locked condition, verticalinterference prevents movement of the hinge. FIG. 7B shows how in theunlocked condition the spring element is compressed, and the detent maymove.

FIGS. 8A and 8B exemplify a variation of the hinge 96, whereby the mainsupport and the lower support define a plurality of cooperating teeth98, 100 engageable when the lock mechanism is in the locked condition,and disengaged from one another when the lock mechanism is in anunlocked condition.

FIGS. 9A and 9B illustrate another embodiment of the hinge 102 whereinthe end portion of the elongate element 34 defines an opening 104 andthe main support 16 defines an opening 112 through which a post 114 ofthe lower support 20 extends to secure to the cover 68. Such aconstruction is similar to the embodiments of FIGS. 7A-8B. The opening112 and the post 114 are coaxial along axis 118. The opening 104 of theelongate element 34 has an oblong profile arranged for being axiallyoffset relative to the axis 118, and a first surface 111 is arranged forabutting the hinge cover 68.

The elongate element 34 defines at least one elongate bar 120 protrudingfrom a second surface 113 thereof and is arranged for being received bya corresponding elongate recess 106 formed by the main support 16. Themain support 16 defines a plurality of circumferentially spaced recesses108 arranged for receiving at least one detent 122 formed by theelongate element 34. The main support 16 defines an annular shoulder 110from a first surface 105 thereof and defined about the opening 112.

The main support 16 defines a plurality of receptacles 124circumferentially spaced about the opening 112 along a second surface107 thereof. The lower support 20 defines a plurality ofcircumferentially spaced bosses 116 along a first surface 109 thereof,arranged for being received by the receptacles 124.

FIG. 10 exemplifies another embodiment of an anterior support 202 for acervical collar 200 having a height adjustment system while preservingthe contour 222 of the upper support 214 generally from the Miami Jcollar. The upper support 214, however, has improvements for securing tothe main support 204 and features for increasing lateral immobilization.

The upper support 214 is arranged for easy attachment to the mainsupport 204 by providing snap connections. A central portion at thefront section of the main support 204 may have boss snaps 218 that fitand interlock with a corresponding aperture defined by the main support204. Rear portions of the upper support 214 may define aperturescorresponding to fasteners 220 formed by the main support 204 thatengage the upper support 214, and aid in maintaining the upper support214 in a desirable contour. The ability to easily attach an uppersupport to the main support enables a clinician to use differently-sizedupper supports according to the user's anatomy. The upper and mainsupports may define apertures arranged for receiving fasteners notformed by either support, but are separate elements for securing theupper and main supports together.

The upper support 214 defines lateral extensions 226 on opposed sidesthereof which are oriented to extend away from the central portion ofthe upper support, and effectively lengthen the extent the upper supportextends along a user's mandibles. The lateral extensions are found toaid in increasing lateral immobilization of a user when wearing thecollar.

The anterior support 202 includes a lower support 206 hingedly connectedto the main support 204, and the locking and unlocking of the hinge isobtained by a lock mechanism 212 that may be similar to any of theaforementioned embodiments. A lower or sternum pad 210 is attached to alower or lowermost portion of the lower support 206. The lower support206 may include an adjustment mechanism 208 for adjusting pressuresand/or height of the lower pad 210 relative to the user's sternum.

Anterior support 202 has a cover 216 at the rearwardly portions, incontrast to the centrally located lock mechanism 212. The cover 216generally covers the hinge connection between the main support 204 andthe lower support 206, and further serves form part of the hingeconnection. Specifically, the cover 216, forms a plurality of openings232 through which posts 230 extend from the main support 204.

FIG. 11 depicts an embodiment of an elongate element or slidelock 240useable in the hinge connection of the collar 200. The slidelock 240defines a central rack 242 of teeth arranged to correspond andoperatively engage elements forming part of the lock mechanism forenabling linear translation of the slidelock 240 relative to the mainsupport, such as in the embodiment of FIGS. 3A-4. The elements of thelock mechanism may be similar to the pinion of FIG. 4, or may be alinear rack of teeth, or any other suitable feature or mechanism forengaging the central rack 242.

In this embodiment, as shown in FIG. 10, the slidelock 240 preferablyslides over an outer surface of the main support 204 to cooperate withthe main support 204 to arrest or prevent rotation of the lower support206 relative to the main support 204. The main support 204 and the cover216, as shown below, operate to guide the linear movement of theslidelock. The linear movement of the slidelock is intended relative toa rear portion of main support within such discrete section, whileacknowledging that the slidelock is bendable about the arcuate contourof the main support while traveling between opposed directions, asbetter depicted referring to FIG. 3A.

The slidelock 240 defines elongate segments 244 extending from opposedsides of the central rack 242 to paddles 250 located at end portions forforming part of the hinge connection. The paddles 250 generallycorresponding in proximate location to the end portion 257 of the lowersupport 206, to stabilize the end portion 257 in both the locked andunlocked conditions. An opening 251 defined by the paddles 250 isarranged so the paddle 250 corresponds to the end portion 257 in bothlocked and unlocked conditions, whereby it is within the periphery ofthe end portion 257, as exemplified in FIG. 15B. The slidelock 240 formshooks 246, 248 along the elongate segments 244 preferably extending froma first surface of the slidelock that are engageable with elasticelements, as discussed more in connection with FIG. 13.

Referring to FIG. 12, the slidelock 240 preferably defines ramp 258intended to be on Side A of the collar (and ramp 268 intended to be onSide B of the collar in FIG. 14B) preferably extending from a secondsurface of the slidelock 240 where the elongate segments 244 meet thepaddles 250. It is within this area where the travel of the slidelock isintended as traveling linearly. According to the depicted embodiment,the ramp 258 on Side A of the collar generally decreases in height fromthe paddle 250 toward the central rack 242 and from the second surfaceof the slidelock 240.

Referring to FIG. 14B, the ramp 268 on Side B of the collar generallyincreases in height from the paddle 250 toward the central rack 242 andfrom the second surface of the slidelock 240. In this manner, the ramps258, 268 have oppositely oriented configurations to accommodate linearmovement of the slidelock between locked and unlocked conditions so bothSides A, B undergo simultaneously the same locking or unlocking. Theramps 256, 267 have opposite orientations as the ramps 258, 268. Bothramps 258, 268 disengage at the same time from the corresponding ramps256, 267 of the main support 204 in the unlocked condition, and engageat the same time with the corresponding ramps 256, 267 in the lockedcondition.

FIGS. 13 and 14A depict how the slidelock 240 operates relative to othercomponents of the anterior component 202. Specifically, the slidelock240 is slidably held by the main support 204, similarly as in theembodiment of FIGS. 3A-4, and may be likewise contained by the cover216. The main support 204 defines a ramp 256 protruding from an outersurface and configured for engagement with the ramp 258 of the slidelock240, which urges at least one engaging element 259 defined by a rearportion of the lower support 206 to engage at one engaging element 260formed by the cover 216. The ramps 256, 258 effectively wedge the atleast one engaging elements 259, 260 against one another to lock thehinge connection.

According to the depicted example of FIGS. 14 and 15A, the end portion257 of the lower support has a disk shape, and rotates about an axis Z-Zof the disk shape relative to a circular boss 262 of the cover 216. Theend portion 257 may have a central opening 263 coaxial with the axisZ-Z, which engages the boss 262 and is coaxial with an axis Y-Y of theboss 262. The main support 204 has at least one post 261 extendingthrough the opening 263 and through one of the openings 232 of the cover216 for providing stability to rotation of the end portion 257. As theramps 256, 258 engage and disengage, the end portion 257 axially movesrelative to the at least one post 261, and the boss 262 has a sufficientheight to maintain the engagement of the end portion 257 in both thelocked and unlocked conditions. The cooperation of the ramps, andregulation thereof by the slidelock, control the height clearance in thehinge and the freedom of the disengagement of the lower support from themain support and/or cover.

As shown in FIGS. 14A and 15A, the at least one engaging elements 259,260 are teeth adapted to engage one another in a locked condition of thecollar 200. For simplicity, the cover 216 is shown transparently. The atleast one engaging element 259 of the lower support 206 forms teeth thatextend laterally from the disk shape or parallel to the axis Z-Z of theend portion 257. Preferably, the teeth extend laterally relative to thecircumference of the end portion 257, and may extend completely orpartially about the circumference. The at least one engaging element 260of the cover 216 may be teeth oriented arcuately to smoothly engage theteeth of the at least one engaging element 259 of the lower support 206.

FIG. 14C shows how the ramps 256, 258 (for both Sides A and B) fallgenerally within a range of the at least one engaging elements 259, 260to form an engagement zone 299 when the collar is in a locked condition.According to the engagement zone, the ramps 256, 258 wedge against oneanother, and are generally juxtaposed or stacked-up coinciding over theat least one engaging elements 259, 260 to urge them to mesh together toassure secure locking of the main support to the lower support, andhence the cervical collar in a selective angulation. According to theunlocked condition (not shown), the ramp 256 of the slidelock 240 fallsoutside of the engagement zone 299.

It will be understood these are merely examples of the at least oneengaging element, which are envisioned to be provided in differentstructural shapes and orientations, however they are preferably arrangedto engage and disengage to lock or unlock the lower support orientationrelative to the main support. The cover sandwiches the end portion ofthe lower support with the main support, and the cover and main supportare preferably rigidly secured to one another to assure they do not moverelative to one another unlike the lower support relative to the mainsupport in the unlocked condition.

Referring to FIGS. 13 and 15A, the cover 216 may include hooks 252, asmay the main support 204, to support an elastic band 254 suspendedbetween the hook 252 and at least one of the hooks 246, 248 of theslidelock 240. The elastic band 254 assists in assuring the lockmechanism is biased in a locked condition. When the slidelock translatesaccording to actuation by the lock mechanism to an unlocked conditionthat the elastic band is tensioned more than in the locked condition toform a spring return mechanism.

FIG. 15B exemplifies a variation of a cover 264 arranged to fit to themain support 204 by posts 278 arranged for snapping. The main support204 defines receptacles 269 configured and dimensioned to receive theposts 278 extending from the cover 264. The posts 278 are configured anddimensioned to flexibly extend through or into the receptacles 269 butdeflect while pressed through the receptacles 269 to relax once havingpassed the opening to interlock with the main support 204. Various postsand receptacles are formed by the main support or the cover to interlockwith one another.

In the variation of FIG. 15B, the main support 204 defines a boss 265upon which the end portion 257 of lower support 206 rotates about. Theboss 265 may have the receptacles 269 located therewithin to receive theposts 278.

As depicted in FIG. 15B, the end portion 257 defines a plurality ofteeth 266 only disposed about a segment short of the entirecircumference of the end portion 257 to define a range of rotation ofthe lower support 206 relative to the main support 204. It may bepreferable to limit the rotation of the lower support to assure betterselection of angles of the lower support relative to the upper support.

Either the cover 264 or the main support 204 may define at least oneelongate guide 277 to guide the slidelock 240. The cover 264 or mainsupport 204 may define an elongate slot for observing and facilitatingmovement of the slidelock 240, which may cooperate with the elongateguide 277.

In a variation of the embodiments described herein, different springreturn mechanisms may be provided for a slidelock or elongate element,preferably so that once a user releases the lock mechanism, the springreturn mechanism moves the lock mechanism back to the locked condition.The elongate element may include or have attached thereto a springfeature located at one of the end portions or along a length between theend portions arranged to deflect against a static boss located on themain support or other appropriate structure.

Referring to the examples of FIGS. 16A and 16B, a spring feature may beconfigured into the elongate element, either behind or ahead of thehinge. The spring feature may be connected to the elongate element as aseparate component or be formed as part of the elongate element.

FIG. 16A depicts a slidelock 270 having a paddle 271 defining acompression spring feature 272 and extending from an arm 275. The paddle271 defines a frame 273 arranged for compression upon sliding of theslidelock 270, such that the spring feature 272 protrudes outwardly fromthe frame relative to the arm 275. The frame 273 defines interior corneropenings 274, 276 permitting it to be compressed upon activation of theslidelock. The top opening 276 may secure a fastener or pin to the frame273 upon which the paddle 271 compresses.

FIG. 16B depicts a slidelock 280 having a paddle defining a tensionspring feature 282 and extending from an arm 285. The paddle 281 definesa frame 283 arranged for tension upon sliding of the slidelock 280, suchthat the spring feature 282 protrudes inwardly from the frame toward thearm 285. The frame 283 defines interior corner openings 284 permittingthe paddle 281 to be pulled into tension upon activation of theslidelock.

FIG. 17 shows an alternate embodiment of a lock for the hinge whichrelies on a cam feature connected to or extending from the slidelock290. The end portions of the main support and the lower support mayinclude a plurality of peripheral teeth about their peripheries whichare arranged to engage one another as the cam feature is urged againstthe main and lower supports end portions, such that the teeth mesh withone another to prevent movement of the hinge formed by the end portionsof the main support and lower support.

One of the main support or lower support end portions is locatedconcentrically with one another, and one generally within the peripheryof the other. Both the main and lower supports may have an opening intowhich the cam feature can translate in and out of depending on thelocking configuration of the lock mechanism. The main support definesinteriorly facing teeth 294A, 294B located about an interiorcircumference, and the lower support defines at least one movable set ofteeth 296A, 296B that are selectively engageable with the teeth 294A,294B upon movement of the slidelock 290.

The at least one movable set of teeth 296A, 296B may include two blocksbearing the teeth along one side and along another side forming bearingsurfaces 298A, 298B along which the slidelock 290 engages. The twomovable sets of teeth 296A, 296B may form a first opening 295 into whichthe slidelock extends. The slidelock 290 forms a flared end 292 definingfirst and second sloped surfaces 293A, 293B engageable with the bearingsurfaces 298A, 298B for moving the sets of teeth 296A, 296B relative tothe teeth 294A, 294B. The sets of teeth 296A, 296B likewise form asecond opening 297 through which the flared end 292 may be pushedthrough to reduce engagement of the sets of teeth 296A, 296B from theteeth 294A, 294B.

FIGS. 18A-18D represent another hinge connection 300 that may be useablein any of the cervical collar embodiments described herein, particularlywith a lock mechanism. The hinge connection 300 includes a slidelock302, an end portion 304 of a main support, an end portion 306 of a lowersupport, and a cam element 311 located between the end portions 304,306, and in operative engagement with the slidelock 302. The cam element311 includes at least one engaging element 316 of the slidelock 302 thatis engageable with a corresponding at least one engaging element 326 ofthe end portion 306. In this example, the at least one engaging element316 is a plurality of teeth 318, and the at least one engaging element326 are radially extending teeth.

The slidelock 302 is linearly displaceable relative to the end portion304, by at least one pin 308 and slot 310 connection. As shown, theslidelock 302 includes at least one pin 308 that is linearly slidablewithin a corresponding elongate slot 310. In the depicted embodiment,there are three pins 308 and three corresponding elongate slots 310.

FIG. 18B shows the cam element 311 having rear openings 320 arranged toflexibly bias against a periphery of the end portion 306 when in anunlocked condition to urge retraction of the slidelock once releasedinto a locked condition. The cam element 311 further defines frontopenings 324 spaced apart from a boss 322 defined by the end portion 306upon which the end portion 304 rotates, and connected to one anotherfrom a front frame segment 328. The front and rear frame segments 328,330 extend about the boss 322, and are adapted to be tensionedthereabout. The front openings 324 receive pins 309 extending oppositelyto the at least one pin 308, and carried by arms 312 defined by theslidelock 302.

FIG. 18C shows the cam element 311 in a locked condition with the atleast one engaging element 316 engaging the at least one engagingelement 318. The cam element 311 is in a predetermined rest position,whereby the rear frame segment 328 is tensioned about the boss 322 tomaintain the at least one engaging element 316 locked. FIG. 18Dexemplifies the cam element 311 in an unlocked condition whereby the atleast one engaging element 316 is pushed or pulled away from the atleast one engaging element 318, and the front or rear frame segments328, 330 are tensioned.

Turning to FIGS. 19A-19B, the upper support 18 is slidably secured tothe main support 16, such that continuous padding 28 is arranged aboutthe main support 16. The upper support 18 can be locked in positionrelative to the main support 16, after adjusting the correct position.The main support 16 defines an elongate lateral slot 130 and the uppersupport 18 forms an elongate angled slot 132 arranged obliquely relativeto the elongate slot 130 of the main support 16. A slider 126 slidablycouples the main support 16 and the upper support 18 by the lateral andangled slots 128, 130. According to a variation, a knob of the slidermay be rotated to unlock and lock the slider in a desired position. Asseen from the components shown, the rotation my simply comprise a tightfrictional fit of the slider against the main support 16 and the uppersupport 18. The lateral slot 130 is preferably arranged generallyparallel to a length of the main support 16.

The main support 16 preferably defines a stationary element 128proximate the lateral slot 130. The slider 126 has a tightening feature134 for maintaining the lateral and angled slots in a relative positionto another. Adjustment of the mandible angle could also be drivenup/down through a simple rotating cam mechanism. The object is toelevate the posterior aspect of the chin tray to accommodate the slopeof the mandible, thereby increasing stabilization against lateralmovement of the head and C-Spine.

As in the embodiment of FIGS. 2A and 2B, and referring specifically toFIGS. 20 and 21, the adjustment mechanism 24 is located centrally alonga lowermost portion of the lower support 20. The adjustment mechanism 24has a sternal pad 136 adjustable in location relative to the lowersupport 20. The sternal pad 136 is mounted to a ball joint 142. Theadjustment mechanism 24 has an adjustment dial and an extension element144 arranged for adjustably extending relative to the lower support 20.The extension element 144 carries the ball joint 142 at an end thereof.The adjustment mechanism 24 includes a dial 138 for adjusting the lengthof the extension element 144 between the lower support 20 and thesternal pad 136. The dial 138 is accessible by a recess formed by theadjustment mechanism 24.

FIGS. 22A and 22B show a variation of the adjustment mechanism 24including a housing 145 arranged for receiving the extension element 144in a contracted configuration resulting in a reduced or substantiallyminimized distance between the lower support and the sternal pad. Theextension element 145 has a screw thread 147, and the housing 145defines corresponding threads permitting slidable movement between theextension element 145 and the screw thread 147 according to adjustmentof the dial 138.

As in the embodiment of FIGS. 2A and 2B, and referring to FIGS. 23A and23B, a connector 26 connects the anterior component 12 to the posteriorcomponent 14. The connector 26 includes a base element 148 securing to aplate 150, and the base element 148 has a strap guide 152 about which astrap 146 extending from the posterior component 14 extends. Theconnector 26 has a pull tab 154 arranged for detaching the plate 150from the base 148.

FIGS. 24A and 24B display another embodiment of a connector 160 securingto a plate 164. A cap 166 is arranged to extend over the base element162 and secure therewith. The connector 160 includes a pull tab 170arranged for detaching the plate 160 from the base element 162 and thecap 166. The cap 166 defines an opening 168 with the plate 160 forpermitting a strap 172 extending therethrough which secures to theposterior component. The base element 162 defines a platform 178 aboutwhich the strap 172 extends, and the platform 178 has at least oneprotuberance 180 over which the strap 172 extends.

The base element 162 further defines a channel guide 182 proximate tothe opening 168 and through which the strap 172 extends. The baseelement 162 forms at least one detent 188 proximate to the at least oneprotuberance 180 for selective engagement of the strap 172 with the atleast one protuberance 180. When the connector 160 is in a lockedcondition, the at least one protuberance 180 and the at least one detent188 arrest the strap 172 from movement as they are urged against eachother.

The plate 164 defines at least one retainer 186 having a channel 190 forselectively receiving a pin 184 protruding from the base element 162,such that the pin 184 slides within the channel 190 between locked andunlocked conditions of the connector 160. The cap 166 defines a siderecess 174 for sliding the cap 166 and base element 162 relative to theplate 164 and permitting the at least one retainer 186 to movetherewithin. The cap 166 defines a front recess 176 through which thestrap 172 extends.

The features may be employed in different combinations from those shownin a cervical collar. While the foregoing embodiments have beendescribed and shown, alternatives and modifications of theseembodiments, such as those suggested by others, may be made to fallwithin the invention.

1. A cervical collar having an anterior component arranged forconnecting to a posterior component, the anterior component comprising:a main support; a lower support hingedly connected to the main support;a sternum pad; and an adjustment mechanism located on the lower supportand the sternum pad is connected thereto such that the sternum pad ismovable relative to the lower support.
 2. The cervical collar of claim1, wherein the adjustment mechanism is located at a lowermost portion ofthe lower support.
 3. The cervical collar of claim 2, wherein theadjustment mechanism is located centrally at the lowermost portion ofthe lower support.
 4. The cervical collar of claim 1, wherein theadjustment mechanism includes an extension element variably extendablefrom the adjustment mechanism.
 5. The cervical collar of claim 4,wherein the adjustment mechanism includes a dial for adjusting adistance the extension element extends from the adjustment mechanism. 6.The cervical collar of claim 4, wherein the adjustment mechanismincludes a housing arranged for receiving the extension element in acontracted configuration.
 7. The cervical collar of claim 1, wherein themain support carries a lock mechanism for locking rotation of the lowersupport relative to the main support.
 8. The cervical collar of claim 1,wherein the main support is only connected to the lower support at endportions of each of the main support and lower support.
 9. The cervicalcollar of claim 1, wherein the main support carries an upper supportconnected to inside the main support and oriented to face a mandible ofa user.
 10. The cervical collar of claim 9, wherein the upper support ismaintained in a stationary relationship with the main support.
 11. Thecervical collar of claim 9, wherein the upper support is rigid.
 12. Thecervical collar of claim 1, wherein the main support has a generallyarcuate configuration adapted to extend about the mandible of a user,and the lower support has a generally arcuate configuration contouredfor being adapted for securing against a sternum of the user.
 13. Thecervical collar of claim 1, wherein the sternum pad is mounted to a balljoint and the adjustment mechanism has an adjustment dial and anextension element arranged for adjustably extending relative to thelower support.
 14. The cervical collar of claim 1, wherein theadjustment mechanism includes a housing arranged for receiving anextension element in a contracted configuration resulting in a reducedor substantially minimized distance between the lower support and thesternum pad, the extension element having a screw thread, and thehousing defining corresponding threads permitting slidable movementbetween the extension element and the screw thread according toadjustment of a dial associated with the extension element.
 15. Thecervical collar of claim 14, wherein the housing defines a recess fromwhich at least a portion of the dial extends.
 16. The cervical collar ofclaim 1, further comprising a lock mechanism for locking rotation of thelower support relative to the main support, the lock mechanism coupledto a slidelock arranged for operatively engaging end portions of themain support and lower support for locking and unlocking rotation of thelower support relative to the main support.
 17. The cervical collar ofclaim 16, wherein the slidelock defines a central rack of teeth arrangedto correspond to and operatively engage elements forming part of thelock mechanism for enabling linear translation of the slidelock relativeto the main support.
 18. The cervical collar of claim 16, wherein theslidelock slides over an outer surface of the main support to cooperatewith the main support to arrest or prevent rotation of the lower supportrelative to the main support.
 19. A cervical collar having an anteriorcomponent arranged for connecting to a posterior component, the anteriorcomponent comprising: a main support; a lower support hingedly connectedto the main support; a sternum pad; and an adjustment mechanism locatedcentrally at a lowermost portion of the lower support, the sternum padbeing connected to the adjustment mechanism such that the sternum pad ismovable relative to the lower support, the adjustment mechanismincluding an extension element variably extendable from the adjustmentmechanism and securing to the sternum pad, and a housing arranged forreceiving the extension element in a contracted configuration.
 20. Acervical collar having an anterior component arranged for connecting toa posterior component, the anterior component comprising: a rigid mainsupport; a lower support hingedly connected to the rigid main support atcorresponding end portions thereof; a lock mechanism mounted to therigid main support and arranged for locking rotation of the lowersupport relative to the rigid main support at the end portions thereof;a sternum pad; and an adjustment mechanism located centrally at alowermost portion of the lower support, the sternum pad being connectedto the adjustment mechanism such that the sternum pad is movablerelative to the lower support, the adjustment mechanism including anextension element variably extendable from the adjustment mechanism andsecuring to the sternum pad, and a housing arranged for receiving theextension element in a contracted configuration.